Krajnc Nik, Föttinger Fabian, Ponleitner Markus, Kornek Barbara, Leutmezer Fritz, Macher Stefan, Rommer Paulus, Schmied Christiane, Zebenholzer Karin, Zulehner Gudrun, Zrzavy Tobias, Berger Thomas, Pemp Berthold, Bsteh Gabriel
Department of Neurology, Medical University of Vienna, Vienna, Austria.
Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
Mult Scler. 2025 Aug;31(9):1051-1060. doi: 10.1177/13524585251332895. Epub 2025 Apr 22.
The 2024 McDonald criteria for diagnosing multiple sclerosis (MS) include optic nerve involvement as a fifth region for establishing dissemination in space. Optic neuritis (ON) can be detected through optical coherence tomography (OCT) using an inter-eye absolute or percentage difference (IEAD, IEPD) in ganglion cell-inner plexiform layer (GCIPL) thickness.
To compare the diagnostic accuracy of GCIPL IEAD/IEPD with GCL and IPL IEAD/IEPD alone for identifying a history of ON.
This cross-sectional retrospective study included people with MS (pwMS) who underwent an OCT scan. Diagnostic accuracy was assessed using ROC analysis.
A total of 241 pwMS (mean age 34.7 years [SD 9.7], 70.1% female) were included. Sixty-eight (28.2%) patients had a documented history of unilateral ON. GCL IEAD (AUC 0.79, cut-off ⩾ 0.06 mm or ⩾2µm, 58.9% sensitivity, 85.1% specificity) and IEPD (AUC 0.80, cut-off ⩾ 3%, 48.7% sensitivity, 89.8% specificity) demonstrated excellent diagnostic accuracy for unilateral ON, showing non-inferiority to the established GCIPL IEAD/IEPD.
GCL IEAD and IEPD provide strong diagnostic accuracy for identifying unilateral ON and can be effectively used as an alternative to GCIPL IEAD/IEPD to facilitate implementation in clinical routine.
2024年多发性硬化症（MS）的诊断标准将视神经受累作为确定空间扩散的第五个区域。视神经炎（ON）可通过光学相干断层扫描（OCT）检测，利用神经节细胞-内丛状层（GCIPL）厚度的双眼绝对或百分比差异（IEAD、IEPD）。
比较GCIPL IEAD/IEPD与单独的神经节细胞层（GCL）和内丛状层（IPL）IEAD/IEPD在识别ON病史方面的诊断准确性。
这项横断面回顾性研究纳入了接受OCT扫描的MS患者（pwMS）。使用ROC分析评估诊断准确性。
共纳入241例pwMS（平均年龄34.7岁[标准差9.7]，70.1%为女性）。68例（28.2%）患者有单侧ON的记录病史。GCL IEAD（曲线下面积[AUC]0.79，截断值⩾0.06 mm或⩾2µm，灵敏度58.9%，特异度85.1%）和IEPD（AUC 0.80，截断值⩾3%，灵敏度48.7%，特异度89.8%）对单侧ON显示出优异的诊断准确性，不劣于既定的GCIPL IEAD/IEPD。
GCL IEAD和IEPD在识别单侧ON方面具有很高的诊断准确性，可有效替代GCIPL IEAD/IEPD，便于在临床常规中应用。
